IntroductionEven though atopic dermatitis (AD) most often begins in the first year of life, it is not well known whether sleep disturbances occur following the onset of the disease or whether they develop later.AimTo determine the sleep patterns of young children already diagnosed with AD in comparison to a control group by using a validated questionnaire, the Brief Infant Sleep Questionnaire (BISQ).Material and methodsForty-six children with a new diagnosis of AD and 60 healthy children, aged 3–36 months, participated in the study. Their sleep behaviors were assessed using the BISQ along with a structured sociodemographic data form.ResultsIt was found that when compared with healthy children, children with AD did not have decreased daily total sleep duration (p = 0.1); however, it was found that they woke up more frequently at night (52.2% vs. 40%, p = 0.4) and they stayed awake significantly longer than 60 min when they woke up (41.3% vs. 11.7%, p < 0.05). In addition, mothers of children with AD reported that their children had three times as many sleep problems compared to the reports of mothers of healthy children.ConclusionsThe findings of this study showed that sleep disturbance was more common in young children with already diagnosed AD, and the BISQ provided a practical way to assess the sleep patterns. The use of a screening tool to enable early identification and treatment of childhood sleep problems among patients with AD should be encouraged.

High doses of oral calcium or long-term calcium infusions are recommended to correct the hypocalcemia and secondary hyperparathyroidism in patients with hereditary 1,25 dihydroxyvitamin D3-resistant rickets (HVDRR). Preliminary studies revealed that calcimimetics may be a safe and effective therapeutic choice in children with secondary hyperparathyroidism. Our aim was to observe the efficacy of cinacalcet in the normalization of secondary hyperparathyroidism and hypophosphatemia in two siblings aged 2.5 years and 6 months with HVDRR who did not respond to traditional treatment regimes. Both patients were admitted to the hospital with severe hypocalcemia. They were treated with high doses of calcitriol and calcium infusions intravenously. Secondary hyperparathyroidism was normalized temporarily, but did not improve completely. Cinacalcet (0.25 mg/kg) once a day along with the high doses of oral calcium and calcitriol was added to the treatment schedule. After 3 months, biochemical and radiologic findings reverted to normal. Our findings indicate that cinacalcet is effective in normalizing the hyperparathyroidism and hypophosphatemia in these cases and in improving the bone pathology.

Introduction. Down's syndrome (DS) is a common genetic disorder. The families of children with DS generally do not receive sufficient information at the time of the diagnosis. They are dissatisfied with the manner of healthcare professionals. The objective was to evaluate the experiences of mothers of children with DS at the time of the diagnosis and the communicative attitudes of healthcare professionals. Population and methods. Mothers who had children with Down syndrome were included. The experiences of the mothers at the time of diagnosis and the attitudes of the healthcare professionals were evaluated by a semistructured interview. Results. The study sample was 43 mothers. Eight children had been diagnosed with DS prenatally, and 35 had been diagnosed postnatally. Eighteen of the mothers had received the diagnosis in a pediatric clinic, and 16 had been told of the diagnosis in an obstetric clinic. More than half the mothers had received the first information about their child's diagnosis from a pediatrician. Only five of the 43 mothers had received detailed information. Twenty-three of 32 mothers said that they were met with a negative attitude. Generally, the time put aside to inform the families about the diagnosis was less than 5 min. Conclusions. Mothers of DS children want more information about DS from healthcare professionals. Furthermore, they want this information to be delivered in a supportive and sensitive manner. Healthcare professionals, especially pediatricians need to allocate sufficient time to discuss DS and its challenges with the family.

Introduction: The aim of this study was to determine the experiences and attitudes of pediatric residents and medical students about approaching to child who encounters with death and to the family who have lost their child. Materials and Methods: Totally 50 pediatric residents and medical students from the Department of Pediatrics at İnonü University included in this study. A 5-part evaluation form that was prepared by the authors was applied. These parts consist of questions about frequency of experiences with child death, competency levels related to sharing bad news and explaining death to children and family. Results: The mean age of the participants was 26.9±4.0 years and 56% of them Öz Giriş: Bu çalışmada pediatri asistanları ve tıp öğrencilerinin ölümle karşılaşan çocuğa ve çocuğunu kaybeden aileye yaklaşımla ilgili deneyimlerinin ve tutumlarının belirlenmesi amaçlanmıştır. Gereç ve Yöntem: Çalışmaya İnönü Üniversitesi Çocuk Sağlığı ve Hastalıkları Anabilim Dalı'nda çalışan asistan ve tıp öğrencilerinden oluşan 50 kişi katılmıştır. Katılımcılara yazarlar tarafından geliştirilen çocuk ölümleriyle karşılaşma sıklıklarının, kötü haber verme konusunda yeterlilik düzeylerinin ve çocuk veya ailesine ölümün anlatılması ile ilgili tutumlarının sorgulandığı 5 bölümden oluşan bir değerlendirme formu uygulanmıştır. Bulgular: Katılımcıların yaş ortalaması; 26,9±4,0 yıl olup, %56'sı erkektir. Katılımcıların çocuk ölümleriyle karşılaşma oranı %92 idir. Katılımcıların yaklaşık %80'i kendilerini kötü haber verme konusunda yeterli bulmadıklarını ifade etmiştir. Asistanların %68'i, öğrencilerin %76'sı daha önce ölüm veya ölümcül hastalığa yaklaşım konusunda eğitim almadıklarını belirtmiş, katılımcıların tamamı bu konuda eğitimin gerekli olduğunu savunmuşlardır. Katılımcıların %46'sı çocukların 6-7 yaşlarında iken ölümü anlamaya başladıklarını düşünmektedir. Sonuç: Bu çalışmada, çocuk ölümleriyle karşılaşma sıklığının artmasıyla birlikte kötü haber vermede kendini yeterli bulma oranının artmadığı ve kötü haber vermede zorlanmanın ise azalmadığı saptanmıştır. Toplumlarda çocuğa ölüm kavramının anlatılması ve çocuk kaybı yaşayan ailenin teselli edilme şekliyle ilgili bir takım yanlış inanışlar mevcuttur. Çalışmanın sonuçları, hekimlerin ölümle sık karşılaşmalarının kötü haber vermede yeterliliklerinin artmasında tek başına etkili olmadığını ve eğitimin önemli bir yer tuttuğunu göstermektedir. Hekimler tıp eğitimleri sırasında çocukta ölüm kavramının gelişimsel özelliklerini öğrenmeli ve kaybın ardından yaşanan süreci yönetme konusunda gerekli bilgi ve becerilere sahip olmalıdır.

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